Association between alopecia areata and COVID-19: A systematic review
Rachel E. Christensen, Mohammad Jafferany
Abstract
BackgroundCOVID-19 may play a role in various immune-related dermatologic conditions. The relationship between COVID-19 and alopecia areata remains unclear.ObjectiveTo review the existing literature for clinical studies and reports investigating the association between new-onset alopecia areata or the exacerbation of preexisting alopecia areata following infection with SARS-CoV-2.MethodsA systematic review of the literature was performed using PubMed, Embase, and MEDLINE databases from inception to October 2021. Included articles assessed alopecia areata following infection with SARS-CoV-2.ResultsOf 402 total articles, 9 were identified as meeting the inclusion criteria. Six articles described case reports of 7 patients with new-onset alopecia areata following confirmed infection with SARS-CoV-2, and 3 articles reported on alopecia areata recurrence or exacerbation following SARS-CoV-2 infection in patients with preexisting disease. Studies investigating the exacerbation or recurrence of alopecia areata following infection reported mixed findings.LimitationsA majority of the included studies were case reports. The heterogeneity of articles precluded data synthesis.ConclusionAlopecia areata may be a dermatologic manifestation of COVID-19, with cases most often appearing 1 to 2 months following infection. Additional research is necessary to better elucidate the relationship and draw conclusions. COVID-19 may play a role in various immune-related dermatologic conditions. The relationship between COVID-19 and alopecia areata remains unclear. To review the existing literature for clinical studies and reports investigating the association between new-onset alopecia areata or the exacerbation of preexisting alopecia areata following infection with SARS-CoV-2. A systematic review of the literature was performed using PubMed, Embase, and MEDLINE databases from inception to October 2021. Included articles assessed alopecia areata following infection with SARS-CoV-2. Of 402 total articles, 9 were identified as meeting the inclusion criteria. Six articles described case reports of 7 patients with new-onset alopecia areata following confirmed infection with SARS-CoV-2, and 3 articles reported on alopecia areata recurrence or exacerbation following SARS-CoV-2 infection in patients with preexisting disease. Studies investigating the exacerbation or recurrence of alopecia areata following infection reported mixed findings. A majority of the included studies were case reports. The heterogeneity of articles precluded data synthesis. Alopecia areata may be a dermatologic manifestation of COVID-19, with cases most often appearing 1 to 2 months following infection. Additional research is necessary to better elucidate the relationship and draw conclusions.